Located along the shores of Lake Victoria in western Kenya, Homa Bay County is home to 955,060 people and has a fertility rate of 5.2 children per woman compared to the national average of 3.9 children per woman.

The county has several Bays and islands even though the two popular Islands are Mfangano and Rusinga.

While working with the ministry of health officials in outreach activities, we identified a small but populous island with high HIV prevalence and low uptake of contraceptives.

Ringiti Island has a population of 6000 and an estimated HIV prevalence of between 35 to 55% among adults. Majority of people here find it difficult to access health services because of the infrequent public transport and boat trips that take several hours and sometimes require an overnight’s stay.

We planned for a joint outreach with the Ministry of Health using the nearest government health facility called Wakulla Health Centre within the Island as the link facility. We were to offer integrated reproductive health service while the ministry of health staff offer curative services.

“There is only one boat that goes to Ringiti Island and it leaves Mbita at 7.30am, and will take you 3 hours”, a local fore warned us when we enquired about the transport to the proposed outreach site.

Luckily, on the D-day, May 17 2015, the Ministry of Health offered us an engine boat owned by the health center. We left the shores of Mbita town at 7.00 am.

We arrived at Ringiti at around 10.00am and found a group of anxious people waiting for us.

“The doctors are here at last,” they sighed.We set up our service station in a hall provided by the beach leader trying to replicate a hospital setting. We start off with health education prior providing services

The numbers trickled in and at some point we felt overwhelmed as we had to leave the island before the lake gets ‘bad’. For safety reasons, no boat braves the waters beyond 2 p.m. for fear of the afternoon and evening turbulence.

We were at cross roads. “Do we leave all these clients who badly needed our services? Or do we hope that the lake will be calm today and stay longer? We decided to stay until 4pm.

“Please come back again another day,” they told us as we put up our things together in preparation to leave the island.

The journey back to the mainland through Mfangano Island was horrifying. The waves were bad and we all offered silent prayers every time a huge wave tossed the boat sideways out of its forward course.

For a few moments we took solace on the self-proclaimed experience of the coxswain but all confidence was thrown away at the sight of any rising wave- some getting as high as one meter up.

We arrived at the hotel at 8pm.The day was long; the journey was dreadful but worth the hassle. We slept feeling achieved having fulfilled the KMET goal of reaching the unreachable and underserved with quality services.

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Twenty seven year old Irene Atieno had been in constant conflict with her husband regarding the use of a contraceptive method after having their first child who is now two years. She desired to space her pregnancies but the partner argued that family planning would affect her health.

She suggested the use of condoms as an alternative but this too failed since the man had not fully bought into the idea of contraception.
Irene who is also blind decided to go for Depo injections despite her partner’s dissenting opinion. She was persuaded that her choice was right since neither of them was employed nor had a steady income to care for their children and personal needs.

She had attended a crocheting course at Aluor School of the Blind and had a crocheting machine that she would occasionally use to crotchet sweaters for neighbors’ schoolchildren. Each sweater fetches 450 to 600 Kenya Shillings.
Irene divulges that at some point they had a misunderstanding and had to live separate with her husband. She defaulted on the depo jabs and got pregnant as soon as they reconciled the marriage.
The reunion was not long lived and later on she returned to her rural home in Asembo Constituency with two children. The last-born is now six months old.
She swore never to take chances with birth control and once at home, Irene visited Mama Ann Odede Clinic, one of the Huduma Poa Health Network Facilities.

Irene insisted on getting an IUCD reporting that she had once used implants and had hormonal effects on her. In addition, she was aware she had defaulted on Depo before and did not wish to take the risk again. Unfortunately, the Sub County was experiencing IUCD stock outs. She says she was advised to come a few days later after the facility had restocked.
Luckily, she learnt that the said health facility would be holding a joint community outreach with KMET and the Ministry of Health in their village.

We later met Irene at Opiata Beach during the outreach some 15 kilometers from her home. This is where she finally got the non-hormonal method.

“I don’t want to be going back to the hospital after every three months, it is too hectic and easy to forget,” she says of the Injections.
We got in touch with her two months later via phone and Irene assured us that she is doing well save for a little cramping before her menstrual periods. She is optimistic that she will not be getting another child anytime soon until she is ready for one.
“I’ve not had any problem with this coil, and I know I will give birth only when I want now,” adds the special needs mother.Reported by Pamela Nyagol-Quality Assurance Officer

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In the year 2014, the Ministry of Health directed us to ACK Khasoko Mission Health Centre when KMET was on a mission to recruit more facilities into the Huduma Poa Social Franchise from Bumula Sub County.

The sub county has a population of 129,011 and is the second most populous sub county in Bungoma County. A county that records a total fertility rate of 5.0 compared to the national rate of 3.9.

Huduma Poa has worked with the facility for 11 months now in core intervention areas of integrated family planning and integrated management of childhood illnesses (IMCI). The nature of partnership includes staff training, provision of technical support in quality management and offering support supervision.

In addition, KMET supports four community health volunteers attached to the facility to refer clients from the community for health services.

In May 2015, the KMET Huduma Poa program staff and the Executive Director visited the facility to ensure there is uninterrupted service delivery and offer feedback on the progress made in the areas of child health (pneumonia, malaria and diarrheal diseases), family planning and cervical cancer screening.

The health facility had inserted 19 IUCDs, 312 implants and screened 220 clients for cervical cancer in a period of nine months. Joseph Odhiambo, the clinical officer in charge confirmed that indeed long acting and reversible contraceptive methods were not their priority before the partnership.

The only method of contraception being offered then was the injection and male condom.

“I have been here for four years and the short relationship between you KMET and this facility has been a big achievement. One because the first IUCD to be inserted was done when we started the partnership being the first time an IUCD appeared in the records of the facility,” reported Joseph.

Joseph explained that the only period they ever recorded an Implant insertion before, was when a nonprofit organization would occasionally use their room to offer the services using their own personnel and not the hospital’s.

Being the only provider trained on cervical cancer screening and insertion of IUCDs in the facility, Joseph has mentored two other colleagues who were recently recruited with the support of the KMET Quality assurance officer.

He attributes the number of cervical cancer screening and family planning clients to efforts of the community health volunteers.

The four community health volunteers were trained and given job aids on family planning, HIV counseling and cervical cancer for purposes of referrals.

During a roundtable feedback session the CHWs underscored the importance of the training saying that, they have been equipped with facts, which make their work easier.

“KMET has really considered the work of CHVs and trained us; we are not scared when we talk to the community and this has made the four of us unique from the other CHV’s who are not in Huduma Poa,” reported Judith one of the community health volunteers.

She reported a shift in attitude of clients from Depo injections to more long-term methods citing instances when they have had outreaches where clients turn up in large numbers and night falls when more clients are still coming in.

They however challenge KMET to think of a package that can bring men on board in family planning, suggesting options like prostate cancer screening.

The biggest challenge the facility experiences is that there is no health practitioner trained in cryotherapy in the sub county hence they refer clients to the county referral facility which is far away and hampers effective follow-up.

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Hundreds of patients thronged St. Mary’s Catholic Church in Soy mining village, Kwanza Sub-County, almost overwhelming Huduma Poa social franchise team and providers seconded by the MoH.

The outreach had been organized by one of the Huduma Poa Social Franchise clinic, Seed of Hope in collaboration with the Ministry of Health and the most popular church in the area.

In preparation for the outreach, Bernard Baraza, a community health worker (CHW) attached to the franchise clinic and his counterpart liaised with other community health workers around Soymining village to identify the most suitable site for the reproductive health outreach. They identified St. Mary’s Catholic Church and approached the administration.

The chairperson of the church board welcomed the idea saying the church would support any intervention meant to improve the livelihood of the people in the area.

This is also contrary to the common belief that religion is a barrier to family planning. A 2015 study titled: The Influence of Religion and Ethnicity on Family Planning Approval: A Case for Women in Rural Western Kenya concludes that in as much as religion and ethnicity have been found to be of significance in shaping attitudes towards family planning in other settings, the two variables are of no significance among women in Western Kenya.

The CHVs seized the opportunity, distributed posters, and talked to members of the congregation during the Sunday mass. The Soymining outreach and others that the Huduma Poa franchise has held in collaboration with churches and the Ministry of Health is a demonstration of working public, private, partnership in healthcare.

Margarate Nyongesa a CHV from Soymining says the church is one of the ideal venues to hold outreaches because religious leaders boost the trust of community members because of endorsement even if they do not personally talk about the services.

“We are close to our local pastors because our obligations to reach the people are similar therefore this makes our mobilization work easier,” adds Baraza.

Community Health Worker encourages women to touch the IUCD at Nyamaraga SDA church in Migori

On this particular outreach, 41 women received long acting and reversible methods of contraception; 48 were screened for cervical cancer; 75 counseled and tested for HIV.

KMET Huduma Poa Program Officers have since adopted written letter templates customized for church audiences as a mobilization tool for CHWs in addition to posters, and door-to-door mobilization.

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Did you know that the average adult between the ages of 20 and 64 has three or more decayed or missing teeth? If you are missing one or more teeth, there are plenty of reasons to correct the problem. For one thing, a large space between your teeth may affect how you speak or eat. Even if it’s not noticeable, a missing molar can affect how you chew. Remaining teeth may shift and in some cases, bone loss can occur around a missing tooth.

At Kmet some of the options we offer to replace a lost tooth or teeth are through dentures: partial acrylic denture and complete denture.

Tooth decay is also one of the major reason one may need a filling. With today’s advances, you don’t have to suffer from missing teeth. At Kmet, we offer three types of filling: temporary, composite and amalgam filling. Temporary filling is best under the following conditions.
· Following a root canal
· To allow a tooth’s nerve to “settle down” if the pulp became irritated
· If emergency dental treatment is needed (such as to address a toothache)
· For fillings that require more than one appointment – for example, before placement of gold fillings and for certain filling procedures (called indirect fillings) that use composite materials
At Kmet, some options we use to replace a lost tooth or teeth are through dentures: partial acrylic denture and complete denture. This is done if you’ve lost all or most of your teeth. A denture is a removable replacement for missing teeth and surrounding tissues. Two types of dentures are available — complete and partial dentures. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remains.
Other dental services offered are Acrylic crown, acrylic bridge per unit, surgical dismpaction, root canal treatment, polishing and simple extraction.
For more information,CONTACT USTom Mboya Estate, Along Kondele-Nyawita By-pass, off Kisumu Kakamega RoadP.O. Box 6805-40103Kisumu. KenyaTEl: +254 728219528We shall never know all the good that a simple smile can do.Mother Teresa

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Forty two percent of forty four million Kenyans live below the poverty line and access to health care, clean water, sanitation and education is often a luxury.

Large segments of the population are vulnerable socially, economically and politically therefore education is often a luxury for many people and especially those living in the slum areas.

Phelix and Charles who are eight and seven years old respectively ought to graduate but due to poverty every year they see their freinds graduating while they are left behind due to financial challenges that they will never understand. other challenges these children face are insecurity, H.I.V and some children are mentally challenged.

In promoting education services to the un- deserved, Kmet offers affordable charges of five hundred shillings per month and twenty shillings per day for porridge at break time and lunch as most of the target children are from the slum areas of Obunga, Manyatta, Nyawita and Bandani.

Three hundred children have so far benefited from these services since 2013 and this year, fifteen children have been registered for final class awaiting to join class one after three years of brain development that they would have otherwise missed on were it not for Kmet giving them hope.

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An educated child is equipped with the tools to fight poverty and be prepared for a meaningful citizenship, employment, post secondary education and be active participants in the global society.
Education plays a significance role in releasing a child from poverty and that’s why schools provides a safe, supportive environment for children to learn life skills and make friends
But when poverty, irresponsible parents, Drug abuse, HIV/AIDS, and discrimination back at home becomes a challenge we feel that we are not reaching out to those Most Vulnerable Children who need to quench the thirst of education despite fighting all odds to access education.
That’s why The Active Inclusion Project (Active Inclusive of the most Vulnerable Children) in collaboration with KMET and The Ministry of Education Science and Technology through The Kisumu Municipal Education Office ensures that the Most Vulnerable Children (MVC) living in 5 informal settlements in Kisumu Municipality are able to access and complete 9 years of basic education at Early Childhood Development and Education (ECDE) and Primary School levels. The project targets children who are at risk of dropping out and out-of-school children.
The center has adult/catch up classes for primary school level students who dropped out of school due to fee problems or early pregnancies but wish to continue with education…
We caught up with Dorothy Ndoloh in charge of ECDE Centre and this is what she had to say. “In adult/catch up classes we have 17 students of which 10 students have been registered for K.C.P.E. The classes runs as from 4pm to 8pm, majority of students are between 13-35 years but anyone interested can enroll for a fee of 500/= per month”. She explained.
“Working at this center is quite interesting and encouraging because seeing an elder student of 17-/35 years having that interest of being taken through primary syllabus as low as class five with all the zeal is an indication how thirsty they are for education.” She concluded
Anyone interested to enroll or enroll her child can reach to us through the contacts below or as well visit our offices in Tom Mboya estates for more information.
Tom Mboya Estate, Off Kondele-Airport Ring road
P.O.Box 6805-40103.Kisumu, KENYA
Tel (Off):0701-839115
Email:info@kmet.co.ke
Website:http://www.kmet.co.ke